Transgender 101: Episode 5; "Gender Dysphoria" What's up with that?

Last Episode we talked about surgery as it relates to the transgender community. What kinds and why, we really delved into the physical. Today we look at the root. The why of the surgery, why we decide to go through this process, and why we don't. As we discussed last time, some trans folk will never have a single surgical alteration, for those of us that do however need surgery the driving force is typically something modern medicine has dubbed "Gender Dysphoria".

I suppose a good place to start is the textbook definition of the term.

"Gender Dysphoria"
noun MEDICINE
The condition of feeling one's emotional and psychological identity as male or female to be opposite to one's biological sex.

Now for a more detailed look from the folks with the degree's at https://www.psychiatry.org

Gender dysphoria involves a conflict between a person's physical or assigned gender and the gender with which he/she/they identify. People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of their assigned gender.

People with gender dysphoria may often experience significant distress and/or problems functioning associated with this conflict between the way they feel and think of themselves (referred to as experienced or expressed gender) and their physical or assigned gender.

The gender conflict affects people in different ways. It can change the way a person wants to express their gender and can influence behavior, dress and self-image. Some people may cross-dress, some may want to socially transition, others may want to medically transition with sex-change surgery and/or hormone treatment. Socially transitioning primarily involves transitioning into the affirmed gender’s pronouns and bathrooms.

People with gender dysphoria may allow themselves to express their true selves and may openly want to be affirmed in their gender identity. They may use clothes and hairstyles and adopt a new first name of their experienced gender. Similarly children with gender dysphoria may express the wish to be of the opposite gender and may assert they are (or will grow up to be) of the opposite gender. They prefer, or demand, clothing, hairstyles and to be called a name of the opposite gender. (Medical transition is only relevant at and after the onset of puberty.)

Gender dysphoria is not the same as gender nonconformity, which refers to behaviors not matching the gender norms or stereotypes of the gender assigned at birth. Examples of gender nonconformity (also referred to as gender expansiveness or gender creativity) include girls behaving and dressing in ways more socially expected of boys or occasional cross-dressing in adult men. Gender nonconformity is not a mental disorder. Gender dysphoria is also not the same being gay/lesbian.

While some children express feelings and behaviors relating to gender dysphoria at 4 years old or younger, many may not express feelings and behaviors until puberty or much later. For some children, when they experience puberty, they suddenly find themselves unable to identify with their own body. Some adolescents become unable to shower or wear a bathing suit and/or undertake self-harm behaviors.
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|This is the current quick look at a Diagnosis Criteria:|

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides for one overarching diagnosis of gender dysphoria with separate specific criteria for children and for adolescents and adults.

In adolescents and adults gender dysphoria diagnosis involves a difference between one’s experienced/expressed gender and assigned gender, and significant distress or problems functioning. It lasts at least six months and is shown by at least two of the following:

A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
A strong desire to be rid of one’s primary and/or secondary sex characteristics
A strong desire for the primary and/or secondary sex characteristics of the other gender
A strong desire to be of the other gender
A strong desire to be treated as the other gender
A strong conviction that one has the typical feelings and reactions of the other gender

I won't be leaning on this any heavier than showing the modern medical thought on the subject , however I feel its important to provide a backing to what I am saying by regurgitating this dry medical text, hope it sheds a bit of light on the natural side to all of this, as always these terms and definitions are evolving and growing. I am writing this with a knowledge of current evolving thought on the subject and a textbook knowledge informed by a life lived with this condition.

What drives a good portion of Transgender folk's to surgical solutions is the constant and overwhelming discomfort of existing in the "wrong" sex. Its extraordinary to me that people think a decision like this could be made lightly or off the cuff. Nobody could "dupe" a person into changing the form of their genitals, trust me, the prospect of such a surgery is terrifying, even when its a solution to a massive problem in your life. Just like cancer patients fear chemo, you can fear surgery as a trans person. However like cancer in a way the insidious nature of Gender Dysphoria is that the longer its ignored the more layers of damage it does. It can steal months of your life. While it is hard to go out into a world that lacks understanding just on an average day, Dysphoria makes it impossible to walk out the front door, impossible to think clearly enough to make decisions and set life goals. At its worst it forces you into an impossible place, feeling utterly outside the body you are in. Hormones help tremendously, and for some just receiving the proper hormonal balance completely alleviates their dysphoria, allowing them to move on into life happy and complete. Others, like me, experience dysphoria physically as well as mentally. This leads to the remedy of surgery.

We all develop different ways to deal with the more glaring problems caused by gender dysphoria, at best without medical intervention we can generally keep the demons at bay long enough, or at least numb intense bits of our souls constantly enough, to live a life. Its impossible to break down for someone who has always had alignment between sex and gender, how difficult living in this half realm is. Its constantly tugging at your mind, pulling your thoughts away from what your doing. Before you get a diagnosis you feel so lost, just dead and alone. Without the language to describe what is happening you are locked into an impossible dance of pleasing everyone else's idea of what your gender is supposed to be, and what you subconsciously understand but cant voice or articulate.

I know for me there where periods that just to feel like I could fit in I would do hyper masculine things trying to just ignore or heal what I was going through internally. Just coming out and beginning to live authentically relieved so much background stress I didn't know I was carrying with me all the time. All of a sudden all the things people would do that I couldn't comprehend doing before made perfect sense. Like maintaining a circle of friends or talking about your internal world, ever. Dealing with both work and a social life, allowing for others to be a part of your life, these where all super powers other people had. Suddenly when I understood myself and expressed myself properly these things just happened. My dysphoria had made all of it unthinkable because I had to keep so much of me hidden from others. As a child I would write out long rambling diary entries about this discomfort and about my inside world. I would immediately burn the pages, just a way for me to vent off some of the stress by manifesting it physically if even for a few moments. Gender Dysphoria is debilitating at times. Wrenching and forefront at times. Background and fine at times. It's no fun in any form and takes love and acceptance along with medical help to address. When I was growing up there was no language for any of this. Now we have the words and the solutions available. It's amazing. But it's not easy, its tedious and difficult to understand but needs understanding and compassion.

I hope this helps open a bit of a window into Gender Dysphoria. Please feel free to respectfully ask questions, or seek clarification. All outside sources are listed in the article. Thank you so much for reading I hope your day is nothing short of wonderful.